Global, regional, and national time trends in incidence for migraine, from 1990 to 2019: an age-period-cohort analysis for the GBD 2019

Background The majority of epidemiological studies on migraine have been conducted in a specific country or region, and there is a lack of globally comparable data. We aim to report the latest information on global migraine incidence overview trends from 1990 to 2019. Methods In this study, the available data were obtained from the Global Burden of Disease 2019. We present temporal trends in migraine for the world and its 204 countries and territories over the past 30 years. Meanwhile, an age-period-cohort model be used to estimate net drifts (overall annual percentage change), local drifts (annual percentage change in each age group), longitudinal age curves (expected longitudinal age-specific rate), and period (cohort) relative risks. Results In 2019, the global incidence of migraine increased to 87.6 million (95% UI: 76.6, 98.7), with an increase of 40.1% compared to 1990. India, China, United States of America, and Indonesia had the highest number of incidences, accounting for 43.6% of incidences globally. Females experienced a higher incidence than males, the highest incidence rate was observed in the 10–14 age group. However, there was a gradual transition in the age distribution of incidence from teenagers to middle-aged populations. The net drift of incidence rate ranged from 3.45% (95% CI: 2.38, 4.54) in high-middle Socio-demographic Index (SDI) regions to -4.02% (95% CI: -4.79, -3.18) in low SDI regions, 9 of 204 countries showed increasing trends (net drifts and its 95% CI were > 0) in incidence rate. The age-period-cohort analysis results showed that the relative risk of incidence rate generally showed unfavorable trends over time and in successively birth cohorts among high-, high-middle-, and middle SDI regions, but low-middle- and low-SDI regions keep stable. Conclusions Migraine is still an important contributor to the global burden of neurological disorders worldwide. Temporal trends in migraine incidence are not commensurate with socioeconomic development and vary widely across countries. Both sexes and all age groups should get healthcare to address the growing migraine population, especially adolescents and females. Supplementary Information The online version contains supplementary material available at 10.1186/s10194-023-01619-9.

Additional file 1 Figure 1 The world map of age-standardized incidence rate for migraine, 1990-2019

Figure 2
The local drifts of migraine incidence rate in High SDI countries, 1990-2019

Figure 3
The local drifts of migraine incidence rate in High-middle SDI countries, 1990-2019

Figure 4
The local drifts of migraine incidence rate in Middle SDI countries, 1990-2019 The local drifts of migraine incidence rate in Low-middle SDI countries, 1990-2019 The local drifts of migraine incidence rate in Low SDI countries, 1990-2019 Table 1 The lexis diagram of GBD data for the APC model Table 2 Time trends in migraine incidence rate for both sexes in 204 countries, 1990-2019

Figure 2
The local drifts of migraine incidence rate in High SDI countries, 1990-2019 The dots and shaded areas indicate the values of local drift (annual percentage change in incidence rate) and its 95% CIs for migraine in 16 age groups (5-9 to 80-84 years). SDI=Socio-demographic Index.

Figure 3
The local drifts of migraine incidence rate in High-middle SDI countries, 1990-2019 The dots and shaded areas indicate the values of local drift (annual percentage change in incidence rate) and its 95% CIs for migraine in 16 age groups (5-9 to 80-84 years). SDI=Socio-demographic Index.

Figure 4
The local drifts of migraine incidence rate in Middle SDI countries, 1990-2019 The dots and shaded areas indicate the values of local drift (annual percentage change in incidence rate) and its 95% CIs for migraine in 16 age groups (5-9 to 80-84 years). SDI=Socio-demographic Index.

Figure 5
The local drifts of migraine incidence rate in Low-middle SDI countries, 1990-2019 The dots and shaded areas indicate the values of local drift (annual percentage change in incidence rate) and its 95% CIs for migraine in 16 age groups (5-9 to 80-84 years). SDI=Socio-demographic Index.

Figure 6
The local drifts of migraine incidence rate in Low SDI countries, 1990-2019 The dots and shaded areas indicate the values of local drift (annual percentage change in incidence rate) and its 95% CIs for migraine in 16 age groups (5-9 to 80-84 years). SDI=Socio-demographic Index.

Figure 12
Age effects on migraine incidence rate in High SDI countries Age effects indicate age-associated natural history and are shown by the fitted longitudinal age curves of incidence rate (per 100000 person-years) adjusted for period deviations, with the dots and shaded areas denoting incidence rates with 95% CIs. SDI=Socio-demographic Index.

Figure 13
Age effects on migraine incidence rate in High-middle SDI countries Age effects indicate age-associated natural history and are shown by the fitted longitudinal age curves of incidence rate (per 100000 person-years) adjusted for period deviations, with the dots and shaded areas denoting incidence rates with 95% CIs. SDI=Socio-demographic Index.

Figure 14
Age effects on migraine incidence rate in Middle SDI countries Age effects indicate age-associated natural history and are shown by the fitted longitudinal age curves of incidence rate (per 100000 person-years) adjusted for period deviations, with the dots and shaded areas denoting incidence rates with 95% CIs. SDI=Socio-demographic Index.

Figure 15
Age effects on migraine incidence rate in Low-middle SDI countries Age effects indicate age-associated natural history and are shown by the fitted longitudinal age curves of incidence rate (per 100000 person-years) adjusted for period deviations, with the dots and shaded areas denoting incidence rates with 95% CIs. SDI=Socio-demographic Index.

Figure 16
Age effects on migraine incidence rate in Low SDI countries Age effects indicate age-associated natural history and are shown by the fitted longitudinal age curves of incidence rate (per 100000 person-years) adjusted for period deviations, with the dots and shaded areas denoting incidence rates with 95% CIs. SDI=Socio-demographic Index.

Figure 17
Period effects on migraine incidence rate in High SDI countries Period effects are shown by the relative risk of incidence rate (incidence rate ratio) for each period from 1990-1994 to 2015-2019, with the dots and shaded areas representing rate ratios and 95% CIs for a given period relative to the referent period (2000)(2001)(2002)(2003)(2004). SDI=Socio-demographic Index.

Figure 18
Period effects on migraine incidence rate in High-middle SDI countries Period effects are shown by the relative risk of incidence rate (incidence rate ratio) for each period from 1990-1994 to 2015-2019, with the dots and shaded areas representing rate ratios and 95% CIs for a given period relative to the referent period (2000)(2001)(2002)(2003)(2004). SDI=Socio-demographic Index.

Figure 19
Period effects on migraine incidence rate in Middle SDI countries Period effects are shown by the relative risk of incidence rate (incidence rate ratio) for each period from 1990-1994 to 2015-2019, with the dots and shaded areas representing rate ratios and 95% CIs for a given period relative to the referent period (2000)(2001)(2002)(2003)(2004). SDI=Socio-demographic Index.

Figure 20
Period effects on migraine incidence rate in Low-middle SDI countries Period effects are shown by the relative risk of incidence rate (incidence rate ratio) for each period from 1990-1994 to 2015-2019, with the dots and shaded areas representing rate ratios and 95% CIs for a given period relative to the referent period (2000)(2001)(2002)(2003)(2004). SDI=Socio-demographic Index.

Figure 21
Period effects on migraine incidence rate in Low SDI countries Period effects are shown by the relative risk of incidence rate (incidence rate ratio) for each period from 1990-1994 to 2015-2019, with the dots and shaded areas representing rate ratios and 95% CIs for a given period relative to the referent period (2000)(2001)(2002)(2003)(2004). SDI=Socio-demographic Index.

Figure 22
Cohort effects on migraine incidence rate in High SDI countries Cohort effects are shown by the relative risk of incidence rate (incidence rate ratio) for each birth cohort from 1910 to 2010, with the dots and shaded areas represent rate ratios and 95% CIs for a given cohort relative to the referent 1960 cohort. SDI=Socio-demographic Index.

Figure 23
Cohort effects on migraine incidence rate in High-middle SDI countries Cohort effects are shown by the relative risk of incidence rate (incidence rate ratio) for each birth cohort from 1910 to 2010, with the dots and shaded areas represent rate ratios and 95% CIs for a given cohort relative to the referent 1960 cohort. SDI=Socio-demographic Index.

Figure 24
Cohort effects on migraine incidence rate in Middle SDI countries Cohort effects are shown by the relative risk of incidence rate (incidence rate ratio) for each birth cohort from 1910 to 2010, with the dots and shaded areas represent rate ratios and 95% CIs for a given cohort relative to the referent 1960 cohort. SDI=Socio-demographic Index.

Figure 25
Cohort effects on migraine incidence rate in Low-middle SDI countries Cohort effects are shown by the relative risk of incidence rate (incidence rate ratio) for each birth cohort from 1910 to 2010, with the dots and shaded areas represent rate ratios and 95% CIs for a given cohort relative to the referent 1960 cohort. SDI=Socio-demographic Index.

Figure 26
Cohort effects on migraine incidence rate in Low SDI countries Cohort effects are shown by the relative risk of incidence rate (incidence rate ratio) for each birth cohort from 1910 to 2010, with the dots and shaded areas represent rate ratios and 95% CIs for a given cohort relative to the referent 1960 cohort. SDI=Socio-demographic Index

Figure 27 Favorable (A) and unfavorable (B) age-period-cohort effects on exemplary countries across SDI quintiles
Age distribution of incidences shows the relative proportion of incidences from each age group during 1990-2019. Local drifts indicate the annual percentage change of incidence rate (% per year) across five-year age groups (from 5-9 to 80-84 years). Age effects are represented by the fitted longitudinal age curves of incidence rate (per 100,000 person-years) adjusted for period deviations. Period effects are represented by the relative risk of incidence rate (incidence rate ratio) and computed as the ratio of age-specific rates in each period compared to the referent 2000-2004 period. Cohort effects are represented by the relative risk of incidence rate (incidence rate ratio) and computed as the ratio of age-specific rates in each cohort compared to referent 1960 cohort. The shaded areas indicate the corresponding 95% CIs of each point estimate. SDI: Socio-demographic Index.